Association between clinical phenotypes of hypertrophic cardiomyopathy and Ca2+ gene variation gene variation / 中华心血管病杂志

Objective: To observe the association between clinical phenotypes of hypertrophic cardiomyopathy (HCM) patients and a rare calcium channel and regulatory gene variation (Ca2+ gene variation) and to compare clinical phenotypes of HCM patients with Ca2+ gene variation, a single sarcomere gene variation and without gene variation and to explore the influence of rare Ca2+ gene variation on the clinical phenotypes of HCM. Methods: Eight hundred forty-two non-related adult HCM patients diagnosed for the first time in Xijing Hospital from 2013 to 2019 were enrolled in this study. All patients underwent exon analyses of 96 hereditary cardiac disease-related genes. Patients with diabetes mellitus, coronary artery disease, post alcohol septal ablation or septal myectomy, and patients who carried sarcomere gene variation of uncertain significance or carried>1 sarcomere gene variation or carried>1 Ca2+ gene variation, with HCM pseudophenotype or carrier of ion channel gene variations other than Ca2+ based on the genetic test results were excluded. Patients were divided into gene negative group (no sarcomere or Ca2+ gene variants), sarcomere gene variation group (only 1 sarcomere gene variant) and Ca2+ gene variant group (only 1 Ca2+ gene variant). Baseline data, echocardiography and electrocardiogram data were collected for analysis. Results: A total of 346 patients were enrolled, including 170 patients without gene variation (gene negative group), 154 patients with a single sarcomere gene variation (sarcomere gene variation group) and 22 patients with a single rare Ca2+ gene variation (Ca2+ gene variation group). Compared with gene negative group, patients in Ca2+ gene variation group had higher blood pressure and higher percentage of family history of HCM and sudden cardiac death (P<0.05); echocardiographic results showed that patients in Ca2+ gene variation group had thicker ventricular septum ((23.5±5.8) mm vs. (22.3±5.7) mm, P<0.05); electrocardiographic results showed that patients in Ca2+ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (400.6±47.2) ms, P<0.05) and higher RV5+SV1 ((4.51±2.26) mv vs. (3.50±1.65) mv, P<0.05). Compared with sarcomere gene variation group, patients in Ca2+ gene variation group had later onset age and higher blood pressure (P<0.05); echocardiographic results showed that there was no significant difference in ventricular septal thickness between two groups; patients in Ca2+ gene variation group had lower percentage of left ventricular outflow tract pressure gradient>30 mmHg (1 mmHg=0.133 kPa, 22.8% vs. 48.1%, P<0.05) and the lower early diastolic peak velocity of the mitral valve inflow/early diastolic peak velocity of the mitral valve annulus (E/e') ratio ((13.0±2.5) vs. (15.9±4.2), P<0.05); patients in Ca2+ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (399.0±43.0) ms, P<0.05) and lower percentage of ST segment depression (9.1% vs. 40.3%, P<0.05). Conclusion: Compared with gene negative group, the clinical phenotype of HCM is more severe in patients with rare Ca2+ gene variation; compared with patients with sarcomere gene variation, the clinical phenotype of HCM is milder in patients with rare Ca2+ gene variation.

Visualization analysis of research hotspots and trends of midwifery education in China based on CNKI / 中华医学教育探索杂志

Objective:To analyze the research status, development trend and frontier hotspots of midwifery education in China in recent 20 years.Methods:Based on the topic of "midwifery education" or "midwifery teaching", this paper searched the periodical literatures from 2001 to 2021 on CNKI database, and used CiteSpace5.7R5 software to analyze them visually and generate knowledge map.Results:A total of 548 Chinese papers were included in this study, and the annual number of published papers showed an overall upward trend. The research field of midwifery education in China formed an obvious core team, and there was few cooperation among core author groups. Health Vocational Education, Chinese Nursing Education and Chinese Higher Medical Education were the top three journals. The six topics with the highest frequency were midwifery specialty, midwifery personnel, midwifery education, practice teaching, delivery mode and teaching mode, forming 10 clusters of midwifery education. In recent three years, the research of midwifery education in China has gradually changed into simulation teaching, flipped classroom, postpartum rehabilitation and so on. Conclusion:The research scope of midwifery education in China is wide and has formed an obvious core team, but the correlation is weak and there is less communication and cooperation among the research teams. The research in the field of high-level midwifery education is insufficient. Midwifery educators and researchers should pay enough attention to carry out in-depth research on relevant aspects.

Rapid flavonoid-focused sub-chemome characterization of Draconis Sanguis using UPLC-Q-TOF-MS in combination with molecular weight imprinting and mass defect filtering / 中国中药杂志

Draconis Sanguis is a precious Chinese medicinal material for activating blood and resolving stasis, and its effective components are flavonoids. However, the structural diversity of flavonoids in Draconis Sanguis brings great challenges to the in-depth chara-cterization of its chemical composition profiles. To clarify the substance basis of Draconis Sanguis, ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was used in this study to acquire MS data of Draconis Sanguis. The molecular weight imprinting(MWI) and mass defect filtering(MDF) were developed for rapid screening of flavonoids in Draconis Sanguis. Full-scan MS and MS~2 were recorded within the mass range m/z 100-1 000 in positive ion mode. Accor-ding to previous literature, MWI was employed to hunt for reported flavonoids in Draconis Sanguis, and the mass tolerance range of [M+H]~+ was set as ±10×10~(-3). A five-point MDF screening frame was further constructed to narrow the screening range of flavonoids from Draconis Sanguis. Combined with diagnostic fragment ions(DFI) and neutral loss(NL) as well as mass fragmentation pathways, 70 compounds were preliminarily identified from the extract of Draconis Sanguis, including 5 flavan oxidized congeners, 12 flavans, 1 dihydrochalcones, 49 flavonoids dimers, 1 flavonoids trimer and 2 flavonoid derivatives. This study clarified the chemical composition of flavonoids in Draconis Sanguis. Moreover, it also showed that high-resolution MS combined with data post-processing methods such as MWI and MDF could achieve rapid characterization of the chemical composition in Chinese medicinal materials.

Changing trend in diabetes-related death and probability of premature mortality among residents in Yangpu District of Shanghai from 2002 to 2020 / 上海预防医学

ObjectiveTo determine the trend in diabetes-related death and probability of premature mortality among residents in Yangpu District of Shanghai and provide evidence for the formulation of relevant intervention strategies. MethodsMortality and demographic data were collected among residents in Yangpu District of Shanghai from 2002 to 2020. Statistical analysis was conducted using chi-square test with SPSS 21.0 and Excel 2010. Joinpoint regression was used to determine annual percent change （APC）. The mortality was standardized by utilizing the world standard population in 2000. ResultsA total of 25 091 cases of diabetes-related deaths were reported in Yangpu District， Shanghai from 2002 to 2020. The average annual crude mortality of diabetes-related diseases was 122.10/105， which was 116.13/105 in males and 128.23/105 in females. The difference between males and females in crude mortality was statistically significant （P<0.05）. Moreover， primary causes of diabetes-related deaths were diabetes， cardiovascular and cerebrovascular diseases， and tumors. Among diabetic deaths， peripheral circulatory complications accounted for 50.79%， followed by renal complications （16.05%）. The crude mortality in males， females， and total of diabetes-related diseases showed an upward trend， while the standardized mortality remained stable with an upward trend in male and a downward trend in female. Furthermore， the crude mortality in males， females， and total of diabetes complicated with cardiovascular and cerebrovascular diseases showed an increasing trend. In contrast， both the standardized mortality in males and in total showed an increasing trend， while that in females remained stable. The overall crude mortality of diabetes was on the rise， which was increasing in males and stable in females. The overall standard mortality of diabetes was on the decline， which was increasing in males while declining in females. In addition， the probability of premature mortality caused by diabetes-related diseases， cardiovascular and cerebrovascular diseases complicated with diabetes， and diabetes decreased from 2002 to 2020 with no statistical significance. Males showed an upward trend while females showed a downward trend. ConclusionThe mortality of diabetes-related diseases， cardiovascular and cerebrovascular diseases complicated with diabetes， and diabetes among residents in Yangpu District of Shanghai is on the rise. Similarly， standardized mortality and probability of premature mortality in males for all three diseases are also on the rise. It warrants more attention to the health of male diabetes patients and targeted measures to reduce the disease burden.

Application of 6S and PDCA cycle lean management in nursing management of orthopedic trauma surgery / 中华创伤杂志

Objective:To explore the application effect of 6S and PDCA cycle lean management in nursing management of orthopaedic trauma surgery.Methods:A retrospective cohort study was conducted to analyze the clinical data of 80 patients with orthopedic trauma admitted to University-Town Hospital of Chongqing Medical University from January 2020 to November 2021, including 51 males and 29 females; aged 23-68 years [(44.5±9.2)years]. According to the order of operation date, 40 patients from January 2021 to November 2021 received routine management plus 6S and PDCA cycle lean management (lean management group), and 40 patients from January 2020 to December 2020 received routine surgical nursing management (routine management group). The nursing quality score in operating room (instrument and equipment management, surgical instrument preparation, surgical coordination, disinfection and isolation), qualified rate of infection monitoring in operating room (air in operating room, hand hygiene of medical staffs and sterile articles in operating room), surgeons′ satisfaction with operating nurses (circulating nurses and scrub nurses), self- rating anxiety scale (SAS) of patients before operation, incidence of complications at postoperative 12 days and patients′ satisfaction with nurses in operating room at postoperative 2-3 days.Results:The four dimensions of the nursing quality score in operating room in lean management group were (27.8±1.5)points, (18.1±1.1)points, (26.6±1.5)points and (18.1±0.8)points, significantly higher than (23.7±2.3)points, (14.6±1.1)points, (22.4±1.8)points and (13.7±1.1)points in routine management group (all P<0.01). The three dimensions of qualified rate of infection monitoring in operating room in lean management group were all 100%, showing no significant differences in routine management group (75%, 100%, 100%) (all P>0.05). Surgeons′ satisfaction with circulating nurses and scrub nurses in lean management group was 90% and 85%, higher than 73% and 65% in routine management group (all P<0.05). Preoperative SAS in lean management group was (32.5±8.2)points, significantly lower than (54.6±10.7)points in routine management group ( P<0.01). The incidence of postoperative complications in lean management group was 0, significantly lower than 15%(6/40) in routine management group ( P<0.05). Patients′ satisfaction with nurses in operating room in lean management group was 95% (38/40), significantly higher than 78%(31/40) in routine management group ( P<0.05). Conclusion:6S and PDCA cycle lean management can effectively improve the nursing quality of orthopedic trauma surgery, reduce patients′ anxiety and postoperative complications, and improve surgeons′ and patients′ satisfaction, which is worthy of further clinical application.

Application effect of the new model of "5G cloud plus medicine" network and linkage in treatment of patients with severe trauma / 中华创伤杂志

Objective:To explore the effect of the new model of "5G cloud plus medicine" network and linkage in improving the therapeutic effect for patients with severe trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 410 patients with severe trauma admitted to Qingzhou People′s Hospital affiliated to Shandong First Medical University from November 2016 to November 2020. There were 258 males and 152 females, aged 16-80 years [(45.7±16.1)years]. The injury severity score (ISS) ranged from 17 to 55 points [(28.1±7.6)points]. A total of 210 patients with severe trauma were rescued by using the new model of "5G cloud plus medicine" network and linkage from November 1, 2018 to November 30, 2020 (observation group), and another 200 patients with severe trauma were rescued by the traditional treatment mode from November 1, 2016 to October 31, 2018 were selected as the control group. Time to start rescue (time from admission to the start of rescue), CT examination time (time from consultation to completion of CT scan), time to receive blood transfusion (time from blood transfusion request to execution), residence time in emergency room, ISS at postoperative 28 days, proportion of patients with blood transfusion, success rate of rescue and mortality rate were compared between the two groups.Results:Time to start rescue [(2.4±1.1)minutes], CT examination time [(29.1±10.3)minutes], time to receive blood transfusion [(28.1±10.2)minutes] and residence time in emergency room [(3.0±1.1)hours] in observation group were significantly shorter than those in control group [(5.5±1.2)minutes, (42.8±10.1)minutes, (48.5±13.1)minutes, (5.0±1.4)hours] (all P<0.05 or 0.01). ISS was (18.7±2.8)points in observation group, significantly lower than (22.1±3.4)points in control group ( P<0.05). Proportion of patients with blood transfusion was 49.5% (104/210) in observation group, similar with 42.5% (85/200) in control group ( P>0.05). Success rate of rescue was 99.0% (208/210) in observation group, significantly higher than 93.0% (186/200) in control group ( P<0.05). The mortality rate was 4.3% (9/200) in observation group, significantly lower than 8.5% (17/200) in control group ( P<0.05). Conclusion:For patients with severe trauma, the new model of "5G cloud plus medicine" network and linkage can effectively shorten the time to start rescue, CT examination time, time to receive blood transfusion and residence time in emergency room, improve the success rate of rescue and reduce the mortality rate, which is worthy of further promotion.

Clinical effect of fluid resuscitation guided by intra-abdominal pressure and oxygenation index for severe acute pancreatitis patients / 中华危重病急救医学

Objective:To investigate the effect of the liquid resuscitation therapy strategy using intra-abdominal pressure (IAP) and oxygenation index (PaO 2/FiO 2) as the end point in patients with severe acute pancreatitis (SAP). Methods:A retrospective study was performed, including 84 patients with SAP in emergency intensive care unit of Qingzhou Hospital Affiliated to Shandong First Medical University from January 2018 to August 2021. According to the status of fluid balance at admission, all patients were divided into the positive fluid balance group (43 cases) and the negative fluid balance group (41 cases). The clinical data including gender, age, etiology, underlying disease, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) of all patients were collected. Fluid balance, PaO 2/FiO 2, IAP, compliance rate, new mechanical ventilation rate and overall hospital stay of 1 week after admission were recorded and compared between the two groups. Results:After 72 hours of treatment, the cumulative fluid balance was (5 219.5±1 038.4) mL in the positive fluid balance group; IAP was higher than that before treatment [mmHg (1 mmHg≈0.133 kPa): 11.9±2.0 vs. 11.7±2.1], but no significant difference was found ( P > 0.05); PaO 2/FiO 2 was significantly higher than that before treatment (mmHg: 299.8±51.4 vs. 220.5±50.4, P < 0.05). After 72 hours of treatment, the cumulative fluid balance in negative fluid balance group was (-3 542.4±1 310.6) mL; IAP was significantly lower than before treatment (mmHg: 11.4±1.8 vs. 15.2±1.9, P < 0.05); PaO 2/FiO 2 was significantly higher than that before treatment (mmHg: 309.9±50.9 vs. 215.4±49.7, P < 0.05). In the fluid resuscitation goals, after 72 hours of treatment, the compliance rate in the negative fluid balance group was significantly higher than that in the positive fluid balance group [82.93% (34/41) vs. 62.79% (27/43), P < 0.05]; 1 week after admission, the new mechanical ventilation rate in the negative fluid balance group was significantly lower than that in the positive fluid balance group [21.95% (9/41) vs. 41.86% (18/43), P < 0.05]; however, there was no significant difference in overall hospital stay between the two groups (days: 41.2±10.9 vs. 39.1±11.5, P > 0.05). After treatment, 70 patients survived and 14 patients died (including 9 cases in the positive fluid balance group and 5 cases in the negative fluid balance group). Conclusions:Using IAP and PaO 2/FiO 2 to guide liquid therapy could result in effective fluid resuscitation in SAP. The treatment strategy effectively improved prognosis of patients with SAP.

Relationship between snoring and hypertension in middle-aged and elderly residents in Yangpu District， Shanghai / 上海预防医学

ObjectiveTo explore the relationship between snoring and hypertension in middle-aged and elderly residents in Yangpu District， Shanghai. MethodsThe data of this study were obtained from the project of “early screening and comprehensive intervention for high-risk of cardiovascular diseases” carried out by the National Cardiovascular Disease Center in Yangpu District in 2017. Questionnaire survey， physical examination and laboratory test were conducted among permanent residents aged 35‒75 years. Logistic regression model was used to analyze the influence of sleep snoring on hypertension. ResultsA total of 11 100 people with complete data were included in the analysis， The self-reported snoring rate of male was significantly higher than female （48.12% vs 36.21%， χ2=137.70， P<0.01）. The proportion of self-reported occasional snoring， frequent snoring and daily snoring were 14.67%（1 628/11 100）， 7.59%（843/11 100） and 17.50% （1 943/11 100）， respectively， and the prevalence of hypertension gradually increased with the increase of snoring frequency （≤60 years，male： χtrend2=51.83，P<0.01；female： χtrend2=95.01， P<0.01； >60 years， male： χtrend2=9.22， P<0.01； female： χtrend2=27.10， P<0.01）. Multivariate logistic regression analysis showed that in people aged ≤60 years， both men and women， snoring frequency was significantly associated with hypertension after adjusting for education， total family income， smoking， alcohol consumption， diabetes， body mass index （BMI） and waist circumference. In the males： occasional snoring OR （95%CI） was 1.95 （1.36，2.80）， frequent snoring OR （95%CI） was 1.55 （1.04，2.31）， daily snoring OR （95%CI） was 1.92 （1.43，2.59）. In the females： occasional snoring OR （95%CI） was 1.31 （1.08，1.59）， frequent snoring OR （95%CI） was 1.41 （1.07，1.88）， daily snoring OR （95%CI） was 1.63 （1.32，2.00）. But in people aged >60 years， the significant association between snoring frequencies and hypertension did not exist， after adjusting for education， total family income， smoking， alcohol consumption， diabetes， BMI and waist circumference. In the males： occasional snoring OR （95%CI） was 1.31 （0.97，1.78）， frequent snoring OR （95%CI） was 1.22 （0.87，1.73）， daily snoring OR （95%CI） was 1.19 （0.94，1.73）. In the females： occasional snoring OR （95%CI） was 1.06 （0.87，1.29）， frequent snoring OR （95%CI） was 1.30 （0.99，1.72）， daily snoring OR （95%CI） was 1.19 （0.97，1.46）. ConclusionIn people ≤60 years old， snoring is significantly associated with hypertension， so more attention should be paid to sleep snoring monitoring in middle-aged people for early detection of hypertension.

ANA- 12 inhibits spinal inflammation and alleviates acute and chronic pain in rats by targeted blocking of BDNF/TrkB signaling / 南方医科大学学报

OBJECTIVE@#To investigate the inhibitory effect of ANA-12 that blocks brain-derived neurotrophic factor (BDNF)/ tropomyosin receptor kinase B (TrkB) signaling on inflammatory pain in rats and explore the underlying mechanism.@*METHODS@#Forty-two adult SD rats were randomized into BDNF-induced acute pain group (n=24) and CFA-induced chronic pain group. The former group were randomly divided into 4 subgroups, including a control group, ANA-12 treatment group, BDNF treatment group, and BDNF+ANA-12 treatment group; the latter group were subgrouped into control group, CFA treatment group (CFA) and CFA + ANA-12 treatment group. The effects of ANA-12 treatment on pain behaviors of the rats with BDNF-induced acute pain and CFA-induced chronic inflammatory pain were observed. Western blotting was used to examine TrkB signaling and expressions of microglia marker protein Iba1 and TNF-α in the spinal cord of the rats.@*RESULTS@#BDNF injection into the subarachnoid space significantly increased the number of spontaneous paw withdrawal of the rats (P < 0.05), which was obviously reduced by ANA-12 treatment (P < 0.05). The rats with intraplantar injection of CFA, showed significantly increased ipsilateral mechanical stimulation sensitivity (P < 0.05), and ANA-12 treatment obviously increased the ipsilateral foot withdrawal threshold (P < 0.05). Treatment with either BDNF or CFA significantly increased the phosphorylation level of TrkB (Y705) in the spinal cord of the rats (P < 0.05), which was significantly lowered by ANA-12 treatment (P < 0.05). Treatment with BDNF and CFA both significantly up-regulated the expressions of Iba1 and TNF-α in the spinal cord (P < 0.05), but ANA-12 significantly reduced their expression levels (P < 0.05).@*CONCLUSION@#ANA-12 can reduce spinal cord inflammation and relieve acute and chronic pain in rats by targeted blocking of BDNF/TrkB signaling.

Cervical Primary Ewing's Sarcoma:Report of One Case / 中国医学科学院学报

Ewing's sarcoma in the cervix is characterized by extremely rare occurrence,high degree of malignancy,and rapid progression.The diagnosis of this disease is based on pathology and immunohistochemistry. The main image of the case reported in this paper showed the cervical cyst with solid mass,large volume,and uneven density and signal,and the solid part can be strengthened in enhanced scanning.Because of the rapid growth,the lesion is prone to liquefaction necrosis and bleeding.Since the metastasis occurs early,timely diagnosis is essential.

Feasibility study of ultrasound-guided percutaneous endomyocardial septal cryoablation of isolated porcine hearts / 中华超声影像学杂志

Objective:To investigate the feasibility of ultrasound-guided percutaneous endomyocardial septal cryoablation of in vitro porcine hearts and to compare its effect with the percutaneous endomyocardial radiofrequency ablation.Methods:Experiment 1: Six in vitro porcine hearts were divided into 1 min ( n=2), 3 min ( n=2) and 5 min ( n=2) groups according to the cryoablation time, and all were subjected to ultrasound-guided percutaneous intra-myocardial septal cryoablation at 100% power respectively. After cryoablation, ultrasound images, the size of the solid dissection of the ice ball, and the size of the necrotic area after melting of the frozen ice ball were measured. Experiment 2: The in vitro porcine hearts were divided into cryoablation group ( n=3) and radiofrequency ablation group ( n=3), and ultrasound-guided percutaneous endomyocardial septal cryoablation and radiofrequency ablation were performed with 100% cryo power and 40 W radiofrequency power, and the extent of complete necrotic area and incomplete necrotic area were compared between the two ablation methods after 1 min. Results:Experiment 1: In the 1 min cryoablation time group ( n=2), the short diameter of the puck measured by ultrasound was (8.00±0.84)mm, the short diameter of the puck measured by solid was (8.38±1.19)mm, and the short diameter of the necrotic zone measured by solid was (8.35±0.83)mm; in the 3 min group ( n=2), the short diameter of the puck measured by ultrasound was (19.4±0.28)mm, and the short diameter of the puck measured by solid was (19.03±0.33)mm, solid measurement of the short diameter of the necrotic zone was (19.16±0.25)mm; in the 5 min group ( n=2), the short diameter of the puck measured under ultrasound was (26.4±2.54)mm, solid measurement of the short diameter of the puck was (26.01±0.24)mm, and solid measurement of the short diameter of the necrotic zone was (24.82±0.25)mm. Randomized blocks analysis of variance was performed on this data and the difference of block Factor b (freezing time: 1 min, 3 min, 5 min) among the three groups was statistically significant( F=505.884, P<0.001). The SNK- q test showed that all three groups differed from each other(all P<0.05). The analysis results for the treatment factors K (measurement modality-ultrasound image measurements, solid anatomical measurements of the puck, and measurements of the necrotic area after melting of the frozen puck) was not statistically significant ( F=0.470, P=0.635). Experiment 2: In the RF ablation group ( n=3), the ratio of incomplete necrotic zone to the radius of the RF ablation area was 0.64±0.01; in the cryoablation group ( n=3), the ratio of incomplete necrotic zone to the radius of the ablation area was 0.26±0.02. The difference was statistically significant( P=0.002) and it can be considered that the incomplete necrotic zone of cryoablation was smaller than that of RF ablation. Conclusions:Percutameous intramyocardial septal cryoablation is controllable in scope, ultrasound image evaluation of ablation area is more accurate and incomplete necrosis area is small, which may have potential applications in cardiac ablation.

Effect of smoking and genetic polymorphisms interaction on the risk of esophageal squamous cell carcinoma / 上海预防医学

Esophageal squamous cell carcinoma （ESCC） is a malignant tumor caused by both environmental and genetic factors. Epidemiology studies have identified smoking as a major environmental risk factor. In recent years， the advancement of genomics research has led to the recognition of the influence of genetic variation in ESCC. We reviewed the research progress in smoking， genetic polymorphism and their interaction on susceptibility to ESCC. Reducing exposure time to tobacco was found to be the most effective way to reduce the risk. At the genetic level， mutations in DNA repair genes， regulation genes of carcinogen-metabolizing enzymes， cell cycle regulation genes， folate metabolism related genes， and alcohol metabolism related genes were found to significantly increase the risk of ESCC. However， studies on the interaction between smoking and genetic polymorphisms in ESCC risk are still limited， more studies are needed for better screening of the high-risk populations and the prevention.

Effect of smoking and genetic polymorphisms interaction on the risk of esophageal squamous cell carcinoma / 上海预防医学

Esophageal squamous cell carcinoma （ESCC） is a malignant tumor caused by both environmental and genetic factors. Epidemiology studies have identified smoking as a major environmental risk factor. In recent years， the advancement of genomics research has led to the recognition of the influence of genetic variation in ESCC. We reviewed the research progress in smoking， genetic polymorphism and their interaction on susceptibility to ESCC. Reducing exposure time to tobacco was found to be the most effective way to reduce the risk. At the genetic level， mutations in DNA repair genes， regulation genes of carcinogen-metabolizing enzymes， cell cycle regulation genes， folate metabolism related genes， and alcohol metabolism related genes were found to significantly increase the risk of ESCC. However， studies on the interaction between smoking and genetic polymorphisms in ESCC risk are still limited， more studies are needed for better screening of the high-risk populations and the prevention.

Anti-tumor Effect of Piceatannol on Triple Negative Breast Cancer Cell Line MDA-MB-468 and Its Mechanism / 中国实验方剂学杂志

Objective:To investigate the effect of piceatannol （PIC） on the proliferation， apoptosis and cell cycle of MDA-MB-468 triple negative breast cancer cells and its mechanism. Method:The methylthiazolyldiphenyl-tetrazoliu bromide （MTT） colcorimetry method was used to investigate the effect of different concentrations of PIC （0， 2.5， 5.0， 10.0， 20.0， 40.0， 80.0， 160.0 μmol·L^-1） on the cell viabilities of triple negative breast cancer MDA-MB-468 cells and calculate the half maximal inhibitory concentration （IC₅₀） value， the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the cell cycle of MDA-MB-468 were investigated by flow cytometry with propidium iodide （PI） staining. The apoptotic effect of PIC （5.0， 10.0， 20.0 μmol·L^-1） on MDA-MB-468 cells in triple negative breast cancer was investigated by flow cytometry with cell apoptosis detection Annexin V-FITC and PI double staining. Western blot was used to investigate the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the proliferation and apoptosis of MDA-MB-468 cells and detect the expressions ofsecreted glycoprotein Wnt/<italic>β</italic>-catenin pathway related proteins. Result:MTT results showed that compared with the blank group， PIC could inhibit the proliferation of MDA-MB-468 cells in a concentration-dependent manner （<italic>P</italic><0.05， <italic>P</italic><0.01）， with IC₅₀ at（39.4±4.6）μmol·L^-1. Compared with the blank group， PIC could increase the percentage of MDA-MB-468 cells in G₀/G₁ phase about cell cycle in a concentration-dependent manner （<italic>P</italic><0.01）. Compared with the blank group， 5.0， 10.0， 20.0 μmol·L^-1 PIC could induce apoptosis of MDA-MB-468 cells for 48 h（<italic>P</italic><0.01）， and the apoptosis rate of MDA-MB-468 cells reached 49.87% when treated with 20.0 μmol·L^-1 for 48 h. Compared with the blank group， PIC could significantly reduce the expressions of <italic>β</italic>-catenin， proto-oncogene （C-myc） and adhesion factor （CD44） proteins in MDA-MB-468 cells， significantly inhibit the phosphorylation of<italic> </italic>protein kinase B （Akt） and p38 mitogen activated protein kinase （p38 MAPK） proteins and the protein expression of B lymphocyte tumor-2 （Bcl-2）， and enhance cysteine aspartic acid protease-3 （Caspase-3）， Bcl-2 related X protein （Bax） and phosphorylated <italic>β</italic>-catenin protein expression（<italic>P</italic><0.01）. Conclusion:PIC may inhibit the proliferation of MDA-MB-468 cells by inhibiting the Wnt/<italic>β</italic>-catenin signaling pathway， block the cell cycle in G0/G1 phase， and induce its apoptosis.

Epidemiological status and survival rate of liver cancer in Yangpu District of Shanghai， 2002-2016 / 上海预防医学

Objective:To analyze the prevalence trend and survival of liver cancer in Yangpu District， Shanghai， from 2002 to 2016. Methods:Data on liver cancer incidence and mortality from 2002 to 2016 were collected from the Shanghai cancer registry system for the registered population in Yangpu District and the number of the registered population published by the public security department. The standardized liver cancer incidence and mortality rates were calculated using the world standard population to analyze the trends of the liver cancer incidence and mortality， in general， by gender and by age. Life table method was used to calculate the survival rate， and log-rank test was used to analyze the difference of 5-year survival rates and the period of diagnosis between patients with liver cancer by gender. Results:The overall incidence and mortality of liver cancer showed a decreasing trend from 2002 to 2016. After removing the influence of community aging， the standardized annual percentage change （APC） of morbidity and mortality was -3.10% （P<0.01） and -3.44% （P<0.01）， respectively. The morbidity and mortality of males were significantly higher than that of females （P<0.01） by Z test. The incidence of liver cancer started to rise obviously from 40 years old， and the death rate raised obviously from 50 years old. 4 007 liver cancer patients were followed up for 5 years. The 5 years observed survival rate was 12.45%， and the median survival time was 281.48 days. The 5-year survival rate of male liver cancer patients was higher than that of female patients， and there was a significant difference（P<0.01）.46.58% of liver cancer patients were diagnosed in the advanced stage， and only 13.46% was diagnosed at the early-stage. There was no statistical difference in the proportion between men and women at different stages （P=0.11）. Conclusion:The overall incidence and mortality rates of liver cancer from 2002 to 2016 show a slowly decreasing trend， with higher incidence and mortality rates in men than in women. Middle-aged and elderly people are still the main population of morbidity and death. The five-year survival rate is low， and the diagnostic periods are mostly in the middle and late stages of cancer.

Electroacupuncture Attenuates Ischemic Brain Injury and Cellular Apoptosis via Mitochondrial Translocation of Cofilin / 中国结合医学杂志

OBJECTIVE@#To investigate the potential mechanisms of electroacupuncture (EA) to prevent ischemic stroke.@*METHODS@#The method of middle cerebral artery occlusion (MCAO) was employed to establish a rat model of ischemic stroke. Seventy-eight Sprague-Dawley rats were divided into the sham group, MCAO + EA control (EC) group, and MCAO + EA (EA) group according to a random number table (n=26 per group). EA was applied to the acupoints of Baihui (DU 20) and Shenting (DU 24) 5 min and 6 h, respectively after the onset of MCAO. Rats in the sham and EC groups received only light isoflurane anesthesia for 30 min after MCAO. The neuroprotective effects of EA were evaluated by rota-rod test, neurological deficit scores and infarct volumes. Additionally, Nissl staining and immunostaining were performed to examine brain damage, rod formation, cellular apoptosis, and neuronal loss induced by ischemia. The activities of caspase-3, and expression levels of cofilin and p-cofilin in mitochondria and cytoplasm after ischemic injury were determined by Western blot.@*RESULTS@#Compared with the EC group, EA significantly improved neuromotor function and cognitive ability after ischemic stroke (P<0.05 or P<0.01). Therapeutic use of EA also resulted in a significant decrease of cofilin rod formation and microtubule-associated protein-2 (MAP2) degradation in the cortical penumbra area compared with the EC rats (P<0.01). Furthermore, Western blot analysis showed that EA stimulation significantly inhibited mitochondrial translocation of cofilin and caspase-3 cleavage (P<0.05 or P<0.01). Additionally, brain damage (infarct volume and neuropathy), cellular apoptosis and neuronal loss induced by ischemia were remarkably suppressed by EA in the cortical penumbra of rats (P<0.05 or P<0.01).@*CONCLUSION@#EA treatment after ischemic stroke may attenuate ischemic brain injury and cellular apoptosis through the regulation of mitochondrial translocation of cofilin, a novel mechanism of EA therapy.

Isomeric discrimination of kaempferol versus luteolin by online energy-resolved mass spectrometry / 中国中药杂志

Isomers are widely distributed in Chinese herbal medicines,and can be discriminated by energy-resolved mass spectrometry( ER-MS). However,ER-MS was performed through direct injection of reference compounds with syringe pump,which encountered a significant technical barrier for high-throughput and automated measurements. Herein,online ER-MS was conducted using LC-MS platform,and a pair of isomers,kaempferol vs luteolin,were employed as a case study to illustrate and assess the utility of online ER-MS for isomeric discrimination. High-resolution tandem mass spectrometry data of both flavonoids were acquired on LC-QE-Orbitrap-MS,and the fragmentation pathways responsible for the primary fragment ions were proposed. The primary signal in MS1 occurred at m/z 285( [M-H]-),and the primary signals of either compound generated by retro-Diels-Alder fragmentation were observed at m/z 151 and 133. The spectral information was subsequently transferred onto LC-Qtrap-MS platform to carry out online ER-MS. Two precursor-to-product ion transition candidates were constructed as m/z 285>151 and 285>133,and either afterward derived a set of pseudo-ion transitions( PITs) and so forth,exactly corresponding to a series of progressive collision energies( eg-5,-8,-11 e V,and so on). All PITs were typed into the monitoring list of multiple reaction monitoring program to generate the peak area datasets. Either dataset was normalized using the highest values in the set and imported into Graph Pad Prism software to plot the Gaus-sian-shaped curve that was termed as the break-down graph. The apex of the regressive curve was termed as optimal collision energy( OCE). The OCE values corresponding to m/z 285>151 were calculated as-29. 06 e V and-35. 71 e V for kaempferol and luteolin,respectively. In the case of m/z 285>133,the OCEs were yielded as-44. 15 e V for kaempferol and-49. 01 e V for luteolin. With re-ference to their chemical structures,the location of hydroxyl group was regarded to be responsible for the differences of either m/z 285>151 or 285>133 between the isomers,attributing to their different bond properties. Above all,online ER-MS offers an eligible tool for isomeric discrimination,and provides meaningful information for the accurate chemical composition characterization based on LC-MS,which is not limited to Chinese herbal medicines.

Analysis of the two-child policy's impact on the fertility level of the residents in Yangpu District, Shanghai / 上海预防医学

Objective To explore the impact of the two-child policy on the fertility level of residents in Yangpu District. Methods Birth registry data were collected from the residents of Yangpu District in Shanghai during January 2015 to December 2018 for the analysis of birth characteristics and its variation after the two-child policy implementation. Results The total fertility rate was higher than 1 only in 2016 that was 1.04, whereas it was about 0.8 in other three years. The number of the second child increased which was inspired by the policy. However, the increment in the number of second child was far less than the decrease in the first child. From 2015 through 2018, the proportion of second children in the total births with local household registration accounted for 18.84%, 20.03%, 26.29% and 24.35%, respectively. From January 2015 to August 2016, the proportion of second children was on the rise slowly, in which the annual percent change(APC)value was 0.34%(P > 0.05). From September 2016 to May 2017, the proportion of second children had shown an obvious increase, and the APC value was 3.97%(P < 0.05). From June 2017 to December 2018, the proportion of second children was on a downward trend, in which the APC value was -0.97%(P < 0.05). Conclusion Favorable fertility policy may not reverse the fertility level in Yangpu District, which remains at a very low level.

Evaluation of myocardial microcirculation perfusion in patients with hypertrophic obstructive cardiomyopathy after Liwen procedure by myocardial contrast echocardiography / 中华超声影像学杂志

Objective:To quantitatively evaluate myocardial microcirculation perfusion changes after percutaneous intracardiac septal radiofrequency ablation (PIMSRA, Liwen procedure) in patients with obstructive hypertrophic cardiomyopathy (HOCM) using myocardial contrast echocardiography (MCE) and to further establish the effect of the procedure and predict the long-term prognosis of patients.Methods:A total of 45 patients with HOCM treated by the Liwen procedure in the First Affiliated Hospital of Air Force Medical University (Xijing Hospital) from July 2019 to June 2020 were included. MCE was performed before and 6 months after surgery, respectively. Time-intensity perfusion curve analysis was performed using QLab 10.8 offline software to obtain quantitative parameters of myocardial microcirculation perfusion including myocardial blood volume (A value), myocardial blood flow velocity (β value), and myocardial blood flow (A×β value), then the changes in parameters before and after the procedure were compared.Results:After the Liwen procedure, the mean septal thickness and mean left ventricular free wall thickness were significantly reduced, accompanied by a significant reduction in the left ventricular outflow tract pressure gradient (LVOT-PG) and mitral regurgitation length, and a significant improvement in mitral systolic antegrade motion (SAM) (all P<0.001). In addition, the left ventricular ejection fraction (LVEF) did not deteriorate significantly ( P=0.560) and the E/e′ ratio decreased after the procedure ( P=0.015). Besides, the A values of both the ventricular septum and the left ventricular free wall were not significantly changed compared to those before procedure ( P>0.05), whereas the β values and A×β values were obviously increased ( P<0.05). Conclusions:Myocardial blood velocity and myocardial blood flow in the septum and left ventricular free wall were significantly increased in patients with HOCM after the Liwen procedure, suggesting a significant improvement in myocardial microcirculation perfusion. MCE provides a non-invasive quantitative evaluation parameters of myocardial microcirculation perfusion for the Liwen procedure for the treatment of HOCM.

Effect of electroacupuncture on rehabilitation of knee joint movement after anterior cruciate ligament reconstruction / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the rehabilitation of knee joint function after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#A total of 140 patients with ACL reconstruction were randomly divided into an observation group (58 cases recruited, 12 cases dropped out) and a control group (65 cases recruited, 5 cases dropped out). The patients in the control group were treated with routine rehabilitation treatment. The patients in the observation group, on the basis of the treatment in the control group, were treated with EA at Fengshi (GB 31), Futu (ST 32), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40), Xuanzhong (GB 39), Diji (SP 8) and Sanyinjiao (SP 6) on the affected side (2 Hz/100 Hz of dilatational wave, 2-5 mA). Each EA treatment lasted 20-30 min, twice a day for 7 days. The swelling degree (d), pain visual analogue scale (VAS), knee joint range of motion (ROM), scores of International Knee Documentation Committee (IKDC) subjective short form and scores of Lysholm were observed in the two groups 1 day, 1 month, 3 months, 6 months and 1 year after operation.@*RESULTS@#One month and 3 months after operation, the swelling degree (d) and VAS scores in the observation group were lower than those in the control group (0.05). One month, 3 months, 6 months and 1 year after operation, the ROM of the knee joint in the observation group was higher than that in the control group (<0.05), the IKDC score and Lysholm score were higher than those in the control group (<0.05). Within one year, there were no relaxations, fractures and other related complications in the two groups. The pivot shift test, anterior drawer test and the Lachman test were all negative.@*CONCLUSION@#EA combined with routine rehabilitation training could obviously reduce the pain of knee joint, improve the swelling degree, increase the ROM of knee joint, promote the functional recovery in patients with ACL reconstruction, which are superior to rehabilitation training alone.